SynthesisBMC health services research2026
Barriers and facilitators to population participation in colorectal cancer screening: an umbrella review.
Synthesis in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- The Association of FIT-Based Colorectal Cancer Screening with Earlier Disease Detection: The Romanian Experience.Cancers · 2026Article
- Health Equity After a Colorectal Cancer Screening Program.JAMA health forum · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundColorectal cancer is the third most common malignancy and the second leading cause of cancer-related death globally. Colorectal cancer screening reduces incidence and mortality by detecting precancerous lesions or early-stage tumors, but low participation, particularly among asymptomatic groups, limits its public health value. Implementation Science and the Theoretical Domains Framework help identify health behavior barriers and facilitators, while Behavior Change Techniques support targeted intervention design.
objectiveThis umbrella review aimed to 1) identify behavioral barriers and facilitators of population engagement in colorectal cancer screening using the Theoretical Domains Framework; 2) develop theory-informed implementation strategies by combining the framework-derived factors with Behavior Change Techniques to improve screening participation, with stratification by screening program type.
methodsFollowing Joanna Briggs Institute umbrella review methodology and PRISMA guidelines, and registered in PROSPERO (CRD420251057739), key databases (PubMed, Web of Science, etc.) were searched in June 2025 for reviews on screening barriers/facilitators. Quality was assessed via Meta Quality Appraisal Tool and Assessment of Multiple Systematic Reviews, evidence confidence via GRADE-CERQual. Barriers/facilitators were categorized by the 14-domain framework, stratified by “organized screening programs” and “opportunistic/mixed screening programs”, and Intervention Mapping matched factors with Behavior Change Techniques for strategy development.
results1,513 records were identified, with 24 eligible reviews (20 systematic, 4 narrative) covering 612 studies. Overlap was negligible (Corrected Covered Area 0.6%), 67% of reviews were low-quality (insufficient bias control). Stratification identified 11 organized screening programs and 13 opportunistic/mixed programs. Top influencing framework domains (48% cumulative) were: 1) Environmental Context and Resources (organized programs: service accessibility barriers; opportunistic programs: economic burden); 2) Optimism (cancer fatalism, unrealistic risk views); 3) Social Influences (physician recommendations, family support). Fourteen domain-specific strategies (e.g., tailored education, economic incentives) were developed, with stratified adaptations for different program types. A conceptual framework diagram summarizes the core logic of “TDF domain - barrier type - BCTs - stratified strategies”.
conclusionThis review identifies eight key findings, with core conclusions (three dominant Theoretical Domains Framework domains, program type-specific stratified barriers) of high evidence strength and marginal domain conclusions of low evidence strength. It confirms multi-level colorectal cancer screening barriers with program type-specific differences and provides a theory-driven “barriers-techniques-strategies” framework. Despite variable quality of included reviews and Western bias, the findings offer reliable guidance for targeted interventions and policy. Future research should empirically test the strategies in randomized controlled trials and explore their applicability in low-resource regions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.